CPT code 93010, cpt 93010, 93010 cpt code

(2022) CPT Code 93010 | Description, Procedure, Guidelines & Reimbursement

CPT 93010 may be billed when a 12-lead or more electrocardiogram results are interpreted and reported by a health provider. Below you can find the official description, the procedure, billing guidelines, and reimbursement of CPT code 93010.

1. Description

The official description of the 93010 CPT code is defined in the CPTs manual as: “Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only.”

93010 cpt code description
Official description of CPT 93010

2. What Is An Electrocardiogram (ECG)?

An electrocardiogram (ECG) is the recording of the heart’s electrical activity and its interpretation by a physician.

The sinoatrial node in the right atrium sends electrical impulses to the heart muscles that contract, resulting in systole.

Electrodes placed on the skin over different regions of the heart record the electrical impulses of heart muscles in those regions, and these recordings are reproduced in a graphic format.

Interpretation of these graphs helps in the correct diagnosis of heart disorders. The graphs produced in diseased conditions, such as acute myocardial infarction, sinus bradycardia, atrial fibrillation, or mitral stenosis, significantly differ from those of a normal healthy heart.

3. Procedure

The 93010 CPT code procedure can be conducted using an ECG machine at a physician’s office, hospital, or at home (using a portable ECG monitor). The patient is required to wear a loose–fitting dress during the test.

The sticky (due to the presence of gel) disclike parts of 12 or more different electrodes are placed on other parts of the skin, such as the chest, wrist, and ankles.

The other ends of the leads remain connected to the recorder. The physician or the technician, under the physician’s direct supervision, performs the ECG.
The machine is started, and the monitor will show the electrical pulses through a continuous graphical representation.

Any weakness in the heart muscle or any irregularity of the heartbeat is traced out during the recording of electrical impulse monitoring.

The ECG is taken for a continuous period. Then, a printout of the recording is made on a strip of paper. At the end of the procedure, the physician interprets the result and prepares the report based on the ECG results.

4. Billing Guidelines

CPT code 93010 is reported to bill only the physician’s “interpretation and report,” not for performing the procedure.

Do not use modifier 26 or TC with this code since the professional and technical parts have different codes.

You can report CPT 99354 until CPT 99360 for ECG monitoring.

You can not bill CPT 93010 in combination with CPT 0525T, CPT 0526T, CPT 0527T, CPT 0528T, CPT 0529T, CPT 0530T, CPT 0531T, or CPT 0532T.

5. Reimbursement  

You can bill a maximum of five units of CPT code 93010 on the same service date. Three units are allowed to prove the medical necessity of the provided procedure.

Below you can find the reimbursement rates for the 93010 CPT code.

CostsRUVs
Facility$8.870.25623
Non-Facility$8.870.25623
CPT 93010 Reimbursement

Resources

https://www.aapc.com/blog/27895-charge-up-your-ecg-documentation/

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57326

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